Trans Abstract

Purpose

The purpose of this study was to analyze the impact of healthcare accreditation and to provide empirical evidence to validate positive effectiveness.

Methods

Six electronic databases (KERIS, KoreaMed, NDSL, Ovid-medline, Embase, Cochrane library) were accessed in May 2016. Keywords used were ‘accreditation’ and ‘Joint Commission on Accreditation of Healthcare Organization (JCAHO)’. Of the initially identified 3,008 articles, 60 studies on healthcare accreditation were selected based on inclusion criteria that are hospital accreditation, accreditation by disease and clinical center accreditation. These were retrieved and analyzed.

Result

The 60 study results were on the impact of healthcare accreditation. Results were classified into four perspectives of Balanced Score Card (Financial, Customer, Internal Process, Learning & Growth). In internal process perspective, results revealed that healthcare accreditation has made a positive impact on “care process and procedure”. In learning & growth perspective, healthcare accreditation has made a positive influence on “leadership”, “organizational cultures” and “change mechanisms”. However, it revealed that healthcare accreditation does not directly affect financial performance. It is also difficult to reach a definitive conclusion that healthcare accreditation programs affect patient satisfaction of customer and clinical outcome of the internal process.

Conclusion

Healthcare accreditation programs provide positive impact on change of care process and building communication-oriented hospital culture. However, more rigorous and diverse research is needed on financial effects and clinical outcomes of healthcare accreditation.

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Appendices

부록. Characteristics selected in 60 studies

Article information Continued

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Figure 1.

Flow chart of the study selection process

Figure 2.

BSC perspective classification

Table 1.

1) national databases

Databases

No

Search term

Number of paper

Notes

KoreaMed

1

hospital accreditation OR healthcare accreditation

113

NDSL

1

의료기관인증 OR 병원인증

116

Search field “Total”

KERIS

1

의료기관인증 OR 병원인증

211

google schalor

1

additional manual search

7

계

447

2) Ovid-Medline

No

Search term

Number of paper

1

exp accreditation/

17,058

2

limit 1 to yr=“2000-2016”

8,807

3

(accreditation and research).mp.

3,540

4

limit 3 to yr=“2000-2016”

2,816

5

(JCAHO and research).mp.

112

6

limit 5 to yr=“2000-2016”

71

7

4 or 6

2,826

8

2 and 7

1,348

3) Embase

No

Search term

Number of paper

#1

‘accreditation’/exp OR ‘accreditation’ AND([article in press]/lim OR [review]/lim OR [short survey]/lim) AND [2000-2016]/py

13,048

#2

accreditation AND research:jt,ink,ab,ti AND ([article in press]/lim OR [erratum]/ lim OR [note]/lim OR [review]/lim OR[short survey]/lim AND [embase]/lim AND [2000-2016]/py

1,223

#3

#1 AND #2

1,195

4) Cochrane Library

No

Search term

Number of paper

#1

accreditation

338

#2

(accreditation and research).mp.

20

#3

(JCAHO and research).mp.

2

#4

#2 OR #3

20

#5

#1 AND #4

18

Publication Year from 2000 to 2016

Search strategies

1) national databases

Databases

No

Search term

Number of paper

Notes

KoreaMed

1

hospital accreditation OR healthcare accreditation

113

NDSL

1

의료기관인증 OR 병원인증

116

Search field “Total”

KERIS

1

의료기관인증 OR 병원인증

211

google schalor

1

additional manual search

7

계

447

2) Ovid-Medline

No

Search term

Number of paper

1

exp accreditation/

17,058

2

limit 1 to yr=“2000-2016”

8,807

3

(accreditation and research).mp.

3,540

4

limit 3 to yr=“2000-2016”

2,816

5

(JCAHO and research).mp.

112

6

limit 5 to yr=“2000-2016”

71

7

4 or 6

2,826

8

2 and 7

1,348

3) Embase

No

Search term

Number of paper

#1

‘accreditation’/exp OR ‘accreditation’ AND([article in press]/lim OR [review]/lim OR [short survey]/lim) AND [2000-2016]/py

13,048

#2

accreditation AND research:jt,ink,ab,ti AND ([article in press]/lim OR [erratum]/ lim OR [note]/lim OR [review]/lim OR[short survey]/lim AND [embase]/lim AND [2000-2016]/py

1,223

#3

#1 AND #2

1,195

4) Cochrane Library

No

Search term

Number of paper

#1

accreditation

338

#2

(accreditation and research).mp.

20

#3

(JCAHO and research).mp.

2

#4

#2 OR #3

20

#5

#1 AND #4

18

Publication Year from 2000 to 2016

Table 2.

Thematic results (n=60)

Thematic categories

Key subthemes (n)

Concept

Examples

Relevant references

Financial perspective

Cost of healthcare accreditation (n=2)

· Cost of accreditation preparation & maintenance

Hospitals are spending a significant amount expenses in order to healthcare accreditation. In particular, hospitals with poor infrastructure spend a lot of initial investment (facility, equipment) [15].

Staff satisfaction was higher in accredited hospitals than in non-accredited hospitals. Among the items, the satisfaction level of ‘ advancement of medical knowledge through training ‘ is highest [19].